Anxiety disorders
What are anxiety disorders?
What are anxiety disorders?
We have all been afraid, that is a normal phenomenon. Fear is our internal alarm that warns us of danger and helps us to avoid dangerous situations. So fear is a must for our survival. People without anxiety often end up in more dangerous situations, making them more often the victims of accidents.
When feelings of anxiety are present without a dangerous situation occurring, or they are blown out of proportion, this can have a serious impact on daily life.
One then speaks of anxiety disorders.
There are various forms of anxiety disorders. According to the DSM-5, 11 types of anxiety disorders can be distinguished:
• Separation anxiety disorder
• Selective mutism
• Social anxiety disorder
• Specific phobia
• Panic disorder
• Agoraphobia
• Generalized anxiety disorder
• Anxiety disorder due to an agent or medication
• Anxiety disorder due to a somatic condition
• Other specified anxiety disorder
• Unspecified anxiety disorder
Separation anxiety disorder:
This form of fear develops during childhood. Every kid is sometimes afraid of being separated from his parents. However, children with 'separation anxiety' are constantly afraid that the person to whom they are attached will come across as something awful.
Selective mutism:
People with selective mutism cannot or do not dare to speak in a social situation. For us as a person, language is the ideal way to communicate. When one cannot or does not dare to express one can end up in social isolation, with all the negative consequences that entails.
Social anxiety disorder
People who suffer from a social anxiety disorder are faced with a great insecurity, fear of not doing well or being rejected when they are in company.
Specific phobia:
Here there is extreme fear for a specific animal, thing or situation. One avoids the anxiety-provoking situation as much as possible. As a result, this form of fear has a lesser impact on social life than anxiety disorders related to social events.
Panic disorder:
This is a disorder in which the patient is suddenly and unexpectedly surprised by severe anxiety. Between the attacks one is anxious to be confronted again with those panic feelings. Usually there is no immediate reason to provoke a panic attack. During a panic attack, the patient has the feeling that he will faint, go crazy or even die.
Agoraphobia:
Agoraphobia manifests itself in situations that arise outside the home, for example using public transport, going into a crowd, queuing in line at the local grocery, etc. People with agoraphobia avoid public places as much as possible and prefer to be accompanied when they have to leave their home.
Generalized anxiety disorder:
Everyday life consists of all sorts of small problems, events, tasks that we manage to bring to a successful conclusion each time (without thinking too long). People with generalized anxiety disorder are constantly worried about all those little worries. This anxiety disorder is characterized by frequent worrying, bad foreboding, being over-anxious, and feeling sad.
Anxiety disorder due to an agent or medication:
Some drugs can provoke a panic disorder, the so-called 'bad trip'. But remembering certain resources can also generate a sense of anxiety. For example, people who stop smoking or other addictive substances can experience (temporarily) anxiety attacks.
How are anxiety disorders treated?
Fear has a neurobiological origin.
Scientific research shows that the brains of people with an anxiety disorder have made other connections than healthy volunteers.
For example, the brains of people with an anxiety disorder show stronger functional connections with the amygdala, the insula, putamen, thalamus, and the posterior cingulate cortex.
Areas such as the posterior cingulate cortex play an important role in determining the activation state of the nervous system. The insula also determines the degree of activation of, inter alia, the sympathetic nervous system, which is predominantly active in danger.
At the same time, the brains of people with an anxiety disorder show less strong functional connections in the forehead areas and the temporal zones. The action of the amygdala is slowed down by frontal areas such as the pregenual anterior cingulate cortex. When this 'brake' does not work properly, the amygdala can become overdrive, which is reflected in a panic attack.
Medication can influence this hyperactivity andusually sedatives (e.g. Xanax, Temesta, and Valium) and antidepressants (e.g. Cipramil, Sipralexa, Seroxat, Serlain) are used.
Neuromodulation such as tDCS, TMS, NFB, tES, etc. can also influence the functioning of the brain areas concerned. Unlike medication, neuromodulation is less likely to cause unpleasant side effects.
The effect of cognitive behavioral therapy cannot be underestimated.
Combining neuromodulation and cognitive behavioral therapy is even advisable.
Neuromodulation influences brain function while behavioral therapy helps the patient prevent a panic attack completely breaks through.
A qEEG can help us determine which neuromodulation technique could have the most effect.
